Sore Throat

In most cases a sore throat results from inflammation of the oropharynx – the area at the back try our child’s mouth that is directly visible when the doc-tor looks with a light and tongue depressor. Inflammation of this area is called pharyngitis, and the tonsils are involved the illness is called tonsillitis. Most acute sore throats are caused by viruses and were often associated with postnasal drainage from colds. A small percentage (about 10 percent) of all sore throats are caused by the bacteria known as group B-hemolytic streptococci. These infections are commonly called strep throat. Chronic throat pain may also be caused by allergy.

Viral sore throat

Most acute sore throats are caused by viruses, usually at the onset of a cold. Throat discomfort tends to be scratchy or raw rather than severely painful and is but one of several complaints, including runny nose, aches, and fever. These symptoms will normally resolve on their own – without antibiotic treatment – in three lays, although occasionally they may last as long to two weeks. If you are concerned about the duration of your child’s sore throat, don’t hesitate to seek advice from her physician.

The special forms of viral sore throat include:

Acute infectious mononucleosis. This illness isn’t primarily among teenagers and is often more indicated. It is significantly more severe than the sore throat associated with a cold. The tonsils are inflamed with, redness, and white patches. The lymph nodes (or “glands”) in the neck usually become swollen and tender as well.

Coxsackie virus can cause herpangina, an illness which painful blisters form in the throat and on the palate. This virus also causes hand-foot-and-mouth disease, in which small blisters appear in mouth and on the tongue, as well as on the hands and soles. Both of these syndromes, while to uncomfortable, resolve without treatment, herpes simplex, the virus that causes cold sores (blisters) on the lips, may erupt in the mouth and throat with a cluster of painful sores. These occur in approximately one percent of children having their first encounter with the herpes virus and will disappear in a week without specific treatment. The herpes virus is known for causing recurrent eruption, but these will occur only in the form of there familiar cold sores on the lip.

Herpes Simplex, the virus that causes cold sores (fever blisters) on the lips, may erupt in the mouth or throat with a cluster of painful sores that resemble tiny blisters. These occur in approximately one percent of children having their first encounter with the herpes virus and will disappear within a week without specific treatment. The herpes virus is known for causing recurrent eruptions, but these will occur only in the form of the more familiar cold sores on the lip.

Strep Throat

Streptococcal sore throats are usually more severe and children have more difficulty swallowing and an absence of typical cold symptoms (such as, cough, or laryngitis). A sudden onset with fever and swollen neck glands is not unusual. They may be inflamed, with swelling, redness, and patches of pus (also called exudate). Occasionally, pain, vomiting, rash, and headache are also present. Strep throat is unusual in young children. In this age-group streptococcus causes chronic nasal infections with thick drainage.

When a child or adolescent develops an uncomfortable sore throat, it is important to determine whether or not Streptococcus is the cause, especially when fever is present. This may be done in the doctor’s office by gently swabbing the throat and performing a rapid strep test. If strep is identified, your child’s doctor will prescribe an appropriate antibiotic. In most cases this will need to be continued for 10 days, although some newer antibiotics require shorter courses.

Whatever medication is prescribed, follow the directions and give your child the entire course of medication, which may extend for a few days after she feels well. Failure to do so might result in a recurrence of illness. Proper treatment tends to shorten the course of the illness and prevents more serious complications. It may also reduce the spread of streptococcal infection to other people and allow an earlier return to school or day care. Most physicians feel that after 24 hours of antibiotic therapy, a child will no longer be contagious.

Occasionally streptococcal infections are accompanied by a sandpaper-textured rash. This syndrome, known as scarlet fever, is treated in the same manner as the more common strep throat and will be equally responsive to antibiotics (see scarlet fever).

Allergen-induced sore throat

Many children develop seasonal allergic complaints, especially in the spring or fall. Swollen nasal passages often lead to frequent mouth breathing that, when accompanied by postnasal drip, results in a sore throat, especially upon awakening. The child with this type of sore throat is not acutely ill and will lack fever and swollen lymph nodes in the neck. Specific treatment options can be re-viewed with your child’s physician (see allergies in children).

Less common causes of sore throat

CANKER SORES (aphthous ulcers) When one or more of these develop toward the back of the mouth, a child will complain of an intense sore throat. Other signs of illness are typically absent. Canker sores do not require antibiotic treatment and gradually resolve over several days(see mouth care and concerns).

ACUTE EPIGLOTTITIS See epiglottitis. Fortunately, this disease has become uncommon because most children are now routinely immunized against haemophilus influenza type B, the bacteria that causes it.

LARYNGITIS/TRACHEITIS When the larynx (vocal cords)and/or the airway just beyond it are inflamed, a child may complain of sore throat. Usually she will point to the mid portion or lower neck if asked where she feels uncomfortable. Hoarseness and coughing (often with a barking quality) are usually present also. If your child is very uncomfortable or has noisy or labored breathing, her physician should be called.

Sore Throat Treatment

Whatever might be the cause of your child’s sore throat, much (if not all) of your treatment at home will involve measures to keep her comfortable and prevent the spread of the infection to others:

  • Rest. When the child is feeling better and the fever has subsided for at least 24 hours, the worst has probably passed.
  • Give liquids of all kinds-either chilled or warm. Acidic juices (orange, lemon, tomato) may cause a stinging sensation in an inflamed throat.
  • Feed her soft foods that won’t irritate the throat.
  • Warm saltwater gargles every few hours may be soothing, if your child is old enough to cooperate.(Mix about ./2 teaspoon of salt in 4 ounces of water.)
  • Acetaminophen (Tylenol and other brands) or ibuprofen (Children’s Motrin and other brands) in doses appropriate for your child’s age and weight can be very helpful in relieving throat pain, fever, headaches, and body aches. Aspirin should not be used to treat sore throats or other acute childhood infections because of its link to Reye’s syndrome, a serious illness affecting both brain and liver tissue(see Reye’s syndrome).
  • Prevent others from sharing your sick child’s toothbrush or silverware. Encourage her to wash her hands frequently during the day, and wash your own hands after handling your child to reduce the risk of spreading the infection.
  • Don’t start treating your child with any leftover antibiotics unless specifically instructed to do so by her doctor. Most sore throats do not respond to antibiotics, and diagnostic tests for strep throat may not be valid if an antibiotic has been taken beforehand. If you feel that your child needs specific treatment for a sore throat, call her doctor for further advice.

Some symptoms require a doctor’s examination; con-tact your physician if your child has any of the following complaints:

  • A sandpaper-textured rash
  • Drooling or difficulty swallowing
  • Severe pain
  • Persistent fever higher than 102°F
  • Sudden onset of severe symptoms
  • Sore throat lasting more than three to five days, especially if fever is present